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Biofilm Formation, Antibiotic Resistance, and Infection (BARI): The Triangle of Death
by
Vincenzo Giordano
Vincenzo Giordano 1 and
Peter V. Giannoudis
Peter V. Giannoudis 2,3,*
1
Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117/2º Andar, Gávea, Rio de Janeiro 22430-160, RJ, Brazil
2
Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds LS2 9LU, UK
3
NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds LS7 4SA, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(19), 5779; https://doi.org/10.3390/jcm13195779 (registering DOI)
Submission received: 29 August 2024
/
Revised: 21 September 2024
/
Accepted: 24 September 2024
/
Published: 27 September 2024
Abstract
Fracture-related infection (FRI) is a devastating event, directly affecting fracture healing, impairing patient function, prolonging treatment, and increasing healthcare costs. Time plays a decisive role in prognosis, as biofilm maturation leads to the development of antibiotic resistance, potentially contributing to infection chronicity and increasing morbidity and mortality. Research exploring the association between biofilm maturation and antibiotic resistance in orthopaedics primarily addresses aspects related to quality of life and physical function; however, little exists on life-threatening conditions and mortality. Understanding the intrinsic relationship between biofilm maturation, bacterial resistance, and mortality is critical in all fields of medicine. In the herein narrative review, we summarize recent evidence regarding biofilm formation, antibiotic resistance, and infection chronicity (BARI), the three basic components of the “triangle of death” of FRI, and its implications. Preoperative, perioperative, and postoperative prevention strategies to avoid the “triangle of death” of FRI are presented and discussed. Additionally, the importance of the orthopaedic trauma surgeon in understanding new tools to combat infections related to orthopaedic devices is highlighted.
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MDPI and ACS Style
Giordano, V.; Giannoudis, P.V.
Biofilm Formation, Antibiotic Resistance, and Infection (BARI): The Triangle of Death. J. Clin. Med. 2024, 13, 5779.
https://doi.org/10.3390/jcm13195779
AMA Style
Giordano V, Giannoudis PV.
Biofilm Formation, Antibiotic Resistance, and Infection (BARI): The Triangle of Death. Journal of Clinical Medicine. 2024; 13(19):5779.
https://doi.org/10.3390/jcm13195779
Chicago/Turabian Style
Giordano, Vincenzo, and Peter V. Giannoudis.
2024. "Biofilm Formation, Antibiotic Resistance, and Infection (BARI): The Triangle of Death" Journal of Clinical Medicine 13, no. 19: 5779.
https://doi.org/10.3390/jcm13195779
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